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ARCHIVED REPORTS_XR0011861
Environmental Health - Public
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EHD Program Facility Records by Street Name
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5491
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3500 - Local Oversight Program
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PR0545028
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ARCHIVED REPORTS_XR0011861
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Entry Properties
Last modified
12/6/2019 5:31:23 PM
Creation date
12/6/2019 4:46:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011861
RECORD_ID
PR0545028
PE
3528
FACILITY_ID
FA0003919
FACILITY_NAME
VAN DE POL ENTERPRISES
STREET_NUMBER
5491
STREET_NAME
F
STREET_TYPE
ST
City
BANTA
Zip
95304
CURRENT_STATUS
02
SITE_LOCATION
5491 F ST
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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2795 2nd Street, Suite Soo � <br /> Davis,CA 95616 <br /> Lab: 530.297.4800 <br /> ANALYT/CAL uc �Fax: 530.297,48M: 530.297,48M.,48M� tib No. 6 <br /> Pro'ect Contact(hardcopy or PDF To): Page of <br /> California EDF.Report? ❑ Yes XLW <br /> C 1-+ N Q hi Chain-of-Custody Record and Analysis Request <br /> CompanylAddress: p , rootff-xbkxVIo 29MpW Mk=cam <br /> ?E)(Eli V 6 <br /> Sampling Company Log Code: Anal q <br /> 12r�1� - Analysis Request <br /> Phone No.: FAX 1 No.: GlobaHD: <br /> � <br /> Ts'P Ct tJum']her. P.O.No: EDF Deily mall Address): oLU <br /> Oir-00CM <br /> Project Name: $ampler Si net _ m ~ N a O <br /> ��� eUYV� o o C) b -- a <br /> Project Address: $ _ z x m N o <br /> Sampling Contal r Preservative Matrix m o ix g N v r <br /> oW comm W W = mQ o <br /> > L!1 O LLJ UJ Z t- J m Q C7 o m ro SO T N L � <br /> E m m a T y c m N <br /> Sample Des! nat�0i7 Date Time v i z = u, z a ' _ = x x Q <br /> o r <br /> `—' h r, w N <br /> 0311 A-00 <br /> -0 0 —IN r <br /> - --0Z <br /> y <br /> *' . <br /> Date Time Recelved by: Remarks: <br /> 0 <br /> Date Time Received by: <br /> it <br /> �_A Dale Time Re iv` by La story: n Silt to: <br /> 63120 3 114 �„7 <br /> Oisfrl a.": White,-Lab,Yeltnw-File,Pink-Originator <br /> FormVcoc 121001,fng <br />���..:�.�-.-���r�.—wry -.�-�.:-;F��-—�•- -T- ---�.-- ��,..- . � ._-... .— - - ��....,,,.,, <br />
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